Prevalencia y caracterización clínica de la nefritis lúpica en los pacientes pediátricos atendidos en el Hospital Roberto Gilbert Elizalde de enero 2014 hasta diciembre 2023.

Abstract

Introduction: Lupus nephritis (LN) is a common complication of systemic lupus erythematosus (SLE) in pediatrics. Understanding its behavior is important due to its associated complications and its impact on patients' quality of life. Objective: To describe the prevalence and clinical characterization of lupus nephritis in pediatric patients treated at Dr. Roberto Gilbert Children's Hospital from January 2014 to December 2023. Methodology: An observational, retrospective, and descriptive study was conducted using non-probability convenience sampling. The freely available JASP v.0.19.1 software was used for the analysis. Results: A total of 142 SLE cases were reviewed. The prevalence of LN was 64.1% (n=91); 17 (18.7%) were the first manifestation of SLE; 56% occurred within the first year after SLE diagnosis. There was a predominance in women (81.3%); the median age was 12 years. Hematuria (56%), arterial hypertension (56%), and edema (34%) were the most frequent clinical manifestations. Nephrotic and nephritic syndrome occurred in 65.9% and 19.8% of cases, respectively. Concomitant extrarenal manifestations were hematological (49.5%), musculoskeletal (47.3%) and cutaneous (42,9%). Laboratory tests included hypocomplementemia, C3–C4 (84.6%), hypoalbuminemia (65.9%), elevated urea (64.8%), hypertriglyceridemia (60.4%), elevated creatinine (27.5%). Presence of antibodies: ds-DNA, anti-histone, anti-nucleosome, and anti-Smith. Renal biopsy (n=45; 49.5%); LN class I (8.9%), Class II (24.4%); Class III (24.4%); Class IV (26.7%); Class V (15.6%); Class VI (0%). Chronic kidney disease (CKD) developed in 6.6%. Three patients died (3.3%). Conclusions: The behavior of LN is consistent with other studies regarding its prevalence, clinical manifestations, laboratory tests, autoimmune profile, and treatment. The need to expand the availability of renal biopsies for patient diagnosis and follow-up was evident.